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FELLOWS COLUMN Speaking with One Voice Mona M. Counts, PhD, CRNP, FNAP, FAANP COLUMN EDITOR: Mary Jo Gagan, PhD, ARNP-C, FAANP Opportunities to work with the media surround nurse practitioners (NPs) continually in their every- day professional activities. Health fairs, outreach programs, professional meetings, grant awards, human interest stories, successful outcomes, new guidelines—all present an opportunity to bring NPs into the limelight. This column will highlight some of the issues confronting NPs who choose to use the media to advance the image and the practice of NPs. PORTRAYAL OF NURSING AND NPs IN THE MEDIA Historically, nurses have been portrayed in very stereotypical ways in the media—cartoon nurses wearing white caps and carrying big needles, as sex objects on television shows, or as ‘‘angels of death’’ in hospitals and long-term care facilities—in all ways, subservient to other professionals or lacking necessary knowledge to make decisions. Today, NPs have the power to change these perceptions. One of the ways this can be done is through the very media that has helped perpetuate the stereotypical image. Acknowledging NPs as independent providers is a relatively recent phenomenon in the eyes of society as well as the media. NPs are slowly coming out from being the hidden providers and ‘‘. breaking free of the old-fashioned perspective of the nurse as handmaiden to the phy- sician .’’ (Milstead, 2004, p. 3). Many factors have led to this change, including the women’s movement, the expanding knowledge in health care, and the increasing need worldwide for qualified healthcare providers. As Dunphy, Younkin, and Smith (2004) state in Advanced Practice Nursing: Essentials for Role Development , ‘‘along with expanded opportunities for women came ideas of an autonomous nursing role, separate and distinct from medicine’’ (as quoted in Joel, 2004, p. 17). In the same publication, Schober’s Global Perspective on Advanced Practice highlights healthcare deliv- ery needs, increasing complexity of health services, advances in knowledge and technology, and the pandemic nature of many healthcare issues as factors leading to the utilization and demand for advanced practice nurses (Joel, pp. 73–96). In the relatively near future, as the role of NPs as independent providers becomes better known, opportunities to promote the profession through the media will emerge, which previously did not exist. As the general pub- lic begins to realize that NPs can prescribe and treat, there will be more opportunities to partner with corporate health entities like pharmaceutical companies, medical equipment manufacturers, and developers of health man- agement tools to promote nursing, increase healthcare delivery services, and improve long-term outcomes. One such company—Johnson & Johnson (2004)—has started herculean efforts to change the image of nursing through a national public media campaign titled ‘‘Discover Nursing,’’ http://www. discovernursing.com. In the past, nurses have not been a public voice for either themselves or their patients. Consequently, this silence has led to misunderstanding and lack of awareness of the nature, scope, and contributions of NPs. This can be seen in the perceptions of NPs by healthcare consumers and the medical community, and even among nurses themselves. It is incumbent upon NPs to discuss their legal scope of practice, the contributions they make to health- care systems, and what this means to improved quality of life and patient outcomes. In other words, if they do not toot their own horn, no one else will toot it for them. NPs must learn to work with the media in order to benefit both the profession and the public. Increasing the general public’s knowledge about what NPs are and the NP philosophy of care will greatly influence health care in the United States. Increasing access to care will influence public opinion, turning the public into advocates for the profession. For example, look at the impact of the media on public opinion and knowledge and the effectiveness of direct- to-consumer marketing by pharmaceutical companies. Envision a time when patients will demand to see an NP in the same way they demand the ‘‘purple pill’’! It is a fact that public opinion influences lawmakers and policymakers, as documented by Ellis and Hartley (2001). There seem to be few questions regarding the differences between ‘‘physicians’’ and ‘‘physician assistants.’’ Yet, how many elected officials could explain how NPs differ from registered Author Mona M. Counts, PhD, CRNP, FNAP, FAANP, is the Elouise Ross Eberly Professor at The Pennsylvania State University, Philadel- phia, Pennsylvania, and can be contacted by e-mail at [email protected]. Acknowledgment The author wishes to thank Regina A. Mayolo, Research Associate, Primary Care Center of Mt. Morris, Inc., for her assistance in the prepa- ration and editing of this column. 292 VOLUME 17, ISSUE 8, AUGUST 2005

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Page 1: Speaking with One Voice

FELLOWS COLUMN

Speaking with One Voice

Mona M. Counts, PhD, CRNP, FNAP, FAANPCOLUMN EDITOR: Mary Jo Gagan, PhD, ARNP-C, FAANP

Opportunities to work with the media surroundnurse practitioners (NPs) continually in their every-day professional activities. Health fairs, outreachprograms, professional meetings, grant awards,human interest stories, successful outcomes, newguidelines—all present an opportunity to bringNPs into the limelight. This column will highlightsome of the issues confronting NPs who choose touse the media to advance the image and the practiceof NPs.

PORTRAYAL OF NURSING AND NPsIN THE MEDIA

Historically, nurses have been portrayed in verystereotypical ways in the media—cartoon nurseswearing white caps and carrying big needles, as sexobjects on television shows, or as ‘‘angels of death’’in hospitals and long-term care facilities—in allways, subservient to other professionals or lackingnecessary knowledge to make decisions. Today, NPshave the power to change these perceptions. One ofthe ways this can be done is through the very mediathat has helped perpetuate the stereotypical image.

Acknowledging NPs as independent providers isa relatively recent phenomenon in the eyes of societyas well as the media. NPs are slowly coming outfrom being the hidden providers and ‘‘. breaking

free of the old-fashioned perspective of the nurse as handmaiden to the phy-sician .’’ (Milstead, 2004, p. 3). Many factors have led to this change,including the women’s movement, the expanding knowledge in health care,and the increasing need worldwide for qualified healthcare providers. AsDunphy, Younkin, and Smith (2004) state in Advanced Practice Nursing:Essentials for Role Development, ‘‘along with expanded opportunities forwomen came ideas of an autonomous nursing role, separate and distinctfrom medicine’’ (as quoted in Joel, 2004, p. 17). In the same publication,Schober’s Global Perspective on Advanced Practice highlights healthcare deliv-ery needs, increasing complexity of health services, advances in knowledgeand technology, and the pandemic nature of many healthcare issues as factorsleading to the utilization and demand for advanced practice nurses (Joel, pp.73–96).

In the relatively near future, as the role of NPs as independent providersbecomes better known, opportunities to promote the profession throughthe media will emerge, which previously did not exist. As the general pub-lic begins to realize that NPs can prescribe and treat, there will be moreopportunities to partner with corporate health entities like pharmaceuticalcompanies, medical equipment manufacturers, and developers of health man-agement tools to promote nursing, increase healthcare delivery services, andimprove long-term outcomes. One such company—Johnson & Johnson(2004)—has started herculean efforts to change the image of nursing througha national public media campaign titled ‘‘Discover Nursing,’’ http://www.discovernursing.com.

In the past, nurses have not been a public voice for either themselves ortheir patients. Consequently, this silence has led to misunderstanding andlack of awareness of the nature, scope, and contributions of NPs. This canbe seen in the perceptions of NPs by healthcare consumers and the medicalcommunity, and even among nurses themselves. It is incumbent upon NPsto discuss their legal scope of practice, the contributions they make to health-care systems, and what this means to improved quality of life and patientoutcomes. In other words, if they do not toot their own horn, no one elsewill toot it for them. NPs must learn to work with the media in order tobenefit both the profession and the public.

Increasing the general public’s knowledge about what NPs are and theNP philosophy of care will greatly influence health care in the United States.Increasing access to care will influence public opinion, turning the publicinto advocates for the profession. For example, look at the impact ofthe media on public opinion and knowledge and the effectiveness of direct-to-consumer marketing by pharmaceutical companies. Envision a time whenpatients will demand to see an NP in the same way they demand the ‘‘purplepill’’!

It is a fact that public opinion influences lawmakers and policymakers, asdocumented by Ellis and Hartley (2001). There seem to be few questionsregarding the differences between ‘‘physicians’’ and ‘‘physician assistants.’’Yet, how many elected officials could explain how NPs differ from registered

AuthorMona M. Counts, PhD, CRNP, FNAP,FAANP, is the Elouise Ross Eberly Professorat The Pennsylvania State University, Philadel-phia, Pennsylvania, and can be contacted bye-mail at [email protected].

AcknowledgmentThe author wishes to thank Regina A. Mayolo,Research Associate, Primary Care Center ofMt.Morris, Inc., for her assistance in the prepa-ration and editing of this column.

292 VOLUME 17, ISSUE 8, AUGUST 2005

Page 2: Speaking with One Voice

nurses? The media provides an opportunity to educate theseindividuals, advance the cause of NPs, and ultimately increasehealthcare services delivered to the consumer.

Indeed, the media can bring a greater awareness of thecritical roles played by all nurses in the spectrum of healthcare. According to Christine E. Burke, PhD, CNM, ‘‘theperception of the providers’ skills becomes the reality for theconsumer’’ (as cited in Stanley, 2005, p. 229). As NPs, it isimperative to work with media to increase public awareness,clarify our scope of practice, and garner support for ourfuture.

As professionals, NPs need to be advocates, not only fortheir patients but also for themselves. Because NPs have tradi-tionally not been outgoing regarding their role in health care,many of the media production types have portrayed them innegative roles or not portrayed them at all. Recall the episodeof the television show ER where the NP was depicted as aditsy sex symbol. This created a furor in the NP community,prompting multiple letters of complaint to the producers. Inthe end, the NP character was eliminated from the show.

MEDIA SKILLS 101

Many people tend to be afraid of talking to the press, butanyone can work with the media as long as they have the righttools. To be effective, it must be done right. Consider the fol-lowing before talking with the media.

What is your message? NPs need to speak with a singlevoice. Media training offered by the American Academy ofNurse Practitioners (AANP, 2005) recommends focusing onthe NP’s ability to address the following:

� Care and cure (NPs provide high-quality, primary, acute,and specialty health care)

� Maintenance and improvement of health (NPs empowerpatients to maintain and improve their health by provid-ing individualized and comprehensive health educationand counseling)

� Future healthcare costs (NPs focus on promoting healthand preventing disease, which reduces healthcare costs).

Accuracy is essential. You need to do your homework. AsBurke says, ‘‘a prerequisite to . successful marketing . isknowledge’’ (Stanley, 2005, p. 250). In addition to your statescope of practice, know your clients’ healthcare needs anddesires, know the services you offer, and know the target popu-lation’s understanding of the role and scope of the NP.

Decide what points you want to make. It is better to havetwo or three key points you can make effectively than to riskbeing edited and key points eliminated from your message. Donot be afraid to restate the points several times. Stay calm andfocused—stay on track with key messages.

Choose your medium carefully—we all have different talents.Predetermine if you are better with the spoken word, writtenword, supporting others, or visual portrayals and build on these

strengths. Participate in media productions in the areas whereyou are strongest and build new skills over time.

Know your media—know who your medical reporters areand who your allies are. Build relationships with these mediarepresentatives and personnel. Use the media when somethingof significance happens that will enhance the role of NPs to themedia audience.

Help the media know you. Have your vita or brief statementof information about yourself ready to send to media sourceswhen events arise in your community, or place it on file withlocal media sources. Make it clear why you are an expert sourceof health information.

NPs need to be the ones who work with newspapers, radio,and television on local health issues. They need to offer theirservices to these media outlets as experts when any issues ofhealth care come to the forefront. The following highlightssome steps you can take to advance your role and contacts withmedia sources in your community.

Most reporters are positive, helpful, and want to get yourpoint to their target audience. Make their life easy by keepingthings brief, providing all the information they need in writing,and doing as much work for them as you can (Camp, 2005).

When communicating your points, it is important to keepin mind that newspapers publish at a 10th grade reading levelor lower, with the higher levels relevant to editorial work. Sothe policy of KISS (keep it simple, stupid) becomes a guidingmantra.

Translate complex ideas into clear, concise language thatcommunicates your message. Connect with your audience andmove them to take action (Howell, 2005).

Avoid using words like ‘‘always’’ and ‘‘never’’ and phraseslike ‘‘I feel ..’’ They are exclusionary and do not allow formultiple models of care. Be careful in offering only positiveremarks toward other professionals and systems—you do notwant to be perceived as negative.

Along these lines, be respectful of your clients. Because NPsserve many of the underserved, advocacy for that populationgroup becomes all important. They have needs that are beingmet, but you must be careful not to portray them in a negativelight.

A picture is worth a thousand words, so do not be afraid tolet the media see you in action. Caution—remember to obtainrelease forms from staff and patients when appropriate.

Be honest. Be sure you can do what you say you can. Famil-iarize yourself with your state scope of practice including thebarriers, history, goals, and the position of professional organi-zations. Remember—scope of practice currently changes dra-matically from state to state.

Do not be afraid to show your passion. Your firm belief inwhat you are doing is communicated through body language orchoice of words and is readily picked up by those in the media.If you are not passionate about your message, find someonewho is to deliver it.

Work with the media individually so that your passion foryour field of expertise comes across, but keep in mind that NPsare found in many different roles and positions. When you

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describe the scope of practice, do not minimize, eliminate, ordisparage what other NPs might be doing.

But what to do if you are interviewed and the interviewerhas a hidden agenda that is negative? This author has found thefollowing hints useful to avoid or reduce the impact ofa reporter’s ‘‘hidden agenda.’’

First, if you have any hint of an agenda ahead of time, do yourhomework. Research the issue, identify as many pertinent facts asyou can, consult colleagues, and know and adhere to yourmessage.

Be careful—do not allow a reporter to lead you off track.Continuously refocus on the point you want to make, be pleas-ant, and do not comment on things you are not preparedfor—off-the-wall comments tend to get you in trouble. Listento each question carefully. If the question cannot be answered,say so—do not feel you have to say something.

Many media training courses are available for both individu-als and organizations. The AANP has offered media training attwo of their national conferences. Additional information onmedia training and how to deal with the media can be found atmultiple sites on the Internet.

The media presents an enormous opportunity for NPs toget their message of who, what, when, where, why, and howacross—to the general public, legislators, policymakers, and thecommunity of health professionals. Unless NPs want someoneelse to determine their policy and practice, they need to workwith the media. NPs can speak with one voice by making themedia their partners—they just need to get out there and do it.

FURTHER READING

Further reading can be obtained from the following sources:AANP. (2005). Retrieved April 18, 2005, from http://www.aanp.org

Bodenheimer, T. S., & Grumbach, K. (2002). Understanding health policy:

A clinical approach (3rd ed.). Lange Medical Books/McGraw-Hill.

Grey Global Group. (2005). Retrieved April 18, 2005, from http://www.

gcigroup.com

Group, T. M., & Roberts, J. I. (2001). Nursing, physician control, and the

medical monopoly. Bloomington: Indiana University Press.

Institute of Medicine. (2005). Retrieved April 18, 2005, from http://www.

iom.edu

Institute of Medicine, Committee on Quality of Health Care in America. (2001).

Crossing the quality chasm: A new health system for the 21st century.

Washington, DC: National Academy Press.

Loma Linda University. (2003). Retrieved April 18, 2005, from http://www.

llu.edu/mission

McCloskey, J. C., & Grace, H. K. (Eds.). (1997). Current issues in nursing

(5th ed.). St. Louis, MO: Mosby-Year Book.

Wing, P., O’Grady, E. T., & Langelier, M. H. (2005). Changes in the legal

practice environment of NPs, 1992 to 2000. American Journal for Nurse

Practitioners, 9(2), 25–37.

REFERENCESCamp, K. (2005). How to generate publicity and deal with the media. Retrieved

April 18, 2005, from http://www.bookcouncil.org.nz

Ellis, J. R., & Hartley, C. L. (2001). Nursing in today’s world (7th ed.).

Philadelphia, PA: Lippincott Williams & Wilkins.

Howell, L. (2005). Media skills training. Retrieved April 18, 2005, from http://

www.mediaskillstraining.com

Joel, L. A. (Ed.). (2004). Advanced practice nursing: Essentials for role devel-

opment. Philadelphia, PA: F.A. Davis.

Johnson & Johnson. (2004). Retrieved April 18, 2005, from http://www.

discovernursing.com

Kenney, J. W. (Ed.). (1996). Philosophical and theoretical perspectives for

advanced nursing practice. Sudbury, MA: Jones and Bartlett.

Milstead, J. (Ed.). (2004). Health policy and politics: A nurses guide. Sudbury,

MA: Jones and Bartlett.

Stanley, J. M. (Ed.). (2005). Advanced practice nursing: Emphasizing common

roles (2nd ed.). Philadelphia, PA: F.A. David.

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